What Is Private Home Care?

Private home care is a service that provides both home health aides and nursing staff into a senior’s residence for a limited or indefinite amount of time to help a person with their activities of daily living (ADLs) and medical care.

Home Health Aides and CNAs

These are trained non-medical caregivers that can provide help with these ADLs. They can provide the following:

Most families interested in private home care in the Boston area are in need of home health aides with nursing services occasionally required. Nurses are available but this comes at a higher cost per hour.

Caregivers

Minute Women caregivers go through a hiring process. They are background checked,reference checked, interviewed and trained.

Caregivers are trained at the beginning and during their career with Minute Women. There are regular checks from our nurses to make sure they are doing their job properly and providing the best possible care for our customers.

Who Are Caregivers?

Most home health aides are female and people of color. It is just the demographics of the people who apply to our jobs. Race conversations become necessary because some older people are prejudice, and we need to know before we place a caregiver in a situation that will not work out.

“All caregivers should have liability insurance, general insurances and be bonded.”

Insurances

The company you hire should have liability insurance, general insurances, and bonded caregivers which are part of the cost of hiring a caregiver. Home care services.

Finally, you will have the opportunity to interview over the phone or in person with your caregiver. Interviewing a caregiver allows you to be in control of who comes into your home.

Training

Many new caregivers have had formal training, obtaining their certification to be a CHHA (Certified home health aide). Also available are CNA’s (certified nurses assistants) who train at school for their profession.

During a caregiver’s career, they should be involved in continued education and refresher courses to ensure the caregiver is continued to be trained. They will learn new techniques and proper ways of providing care to specific segments of people (heart disease, stroke, etc.) and that way are specialized in the care they can provide.

Companionship

When it comes to companionship, there isn’t as much training. A companion is going to provide simple tasks, such as meal preparation, transportation, and companionship.

Companions should still be checked in on by supervisors and nurses to ensure they are doing their job correctly.

Scheduling

Note: The following example is a simplification of how home care companies find aides. Not all businesses are the same. Some companies hire home health aides with little focus on training, background checks, and references, while others companies take the time to interview, background check, reference check, and train their caregivers.

To explain how scheduling works, imagine a large group pool of aides. Each home care company hires their aides differently.

As jobs come in, aides are called that can fill those particular jobs and hours. Sometimes those aides get called from multiple home care companies with different jobs, different hours, in various locations.

When jobs end, those aides then go back into that large group pool and wait for another home care company to call with another job. This is the life of a “per diem” worker.

When families call up looking small amounts of care per day they do not realize most home care companies have a minimum of three or four hours of care at a time. The reason for the minimum hours is because it can become very difficult to fill.

“Caregivers look for jobs that will give them the most amount of hours.”

The Difficulty of Low Hours

The reason minimum hours is the likelihood of caregivers being interested in a caregiving job drops dramatically when it is under four hours of care per day. Understandably, caregivers are doing this for their livelihood, so they are interested in cases with the most amount of hours.

Scheduling a case is done using morning and evening timeframes. Jobs in the morning are before noon and after twelve are day shifts.

When customers look for a 10 am – 2 pm shift, it takes up a caregiver’s morning and afternoon shift, which prevents the caregiver from having a morning and day shift, thus making the job less desirable.

Many caregivers will take these jobs, but let their scheduler know they will leave if another caregiving case that provides them more flexibility and more hours if offered to them.

This is not to say asking for an 11 am – 1 pm shift can not be filled, all home care companies will do their best to provide you excellent service and caregivers, but know that it is harder to fill these jobs with one consistent caregiver.

Because of this, the caregivers may change, and the pool of caregivers willing to take a case in blocks under four hours or during the middle of the day decreases. Usually, lower hour jobs need multiple caregivers to fill it, as there is a high turnover rate.

Overtime

Finally, know that overtime laws do apply to hourly caregivers. So if you are looking to receive more than forty hours of care per week, you should expect to have more than one caregiver unless you are willing to pay for the overtime.

Hourly vs. Live In Private Home Care

Hourly cases usually require a minimum of four-hour blocks and can increase to twenty-four hours per day. If someone needs around the clock hourly care, case managers accomplish this with two twelve-hour shifts.

Once you have over 10-12 hours of care a day, it is worthwhile investigating live-in care.

Live-in care occurs when the caregiver occupies a private room in the client’s home and is there twenty-four hours a day, sleeping throughout the night. They can stay for weeks at a time, or five days in a row, with a new live-in caregiver on the weekends.

“With a live-in caregiver, you’ll have the same caregiver day in and out.”

Benefits of Live-In Care

The benefits of live-in caregivers are that you have fewer caregivers involved in the case versus hourly caregiving. A live-in case can involve either 1-3 caregiver, while a 24 hourly case can involve up to ten caregivers.

Additionally, the caregiver is there at all the times in case of an emergency. There won’t be late excuses, emergencies, car breakdowns, or other problems that come with commuting employees.

When it comes to pricing, flat day rate instead of an hourly rate, which can be substantially less when comparing the two for twenty-four hours a day.

The only stipulation for live-in care is that the caregiver must be able to get a solid night of rest. They can get up once or twice in the middle of the night to help a senior, but they need to be able to sleep. They also need a private room with a tv, and they eat with the older adult. No private bathroom is required.

Also, live-in services require the caregiver to have a private room with a tv. They eat with the senior and make meals together, but no private bathroom is needed.

Cost of Private Home Care

What everyone asks is ‘how much is this going to cost?’

The simple answer is that hourly care will cost anywhere from $22 – $35 per hour. Live-in rates range from $250 – $400 depending on the level of attention that is needed and region of the country you live in. The east coast, including Massachusetts, is on the high end.

If you are interested in finding more about costs of care, this is a great resource, the MetLife Cost of Care Survey. This website will inform you of the cost of home care, assisted living, nursing homes, and adult day care in your state.

Ways to Pay

The three most common ways to pay for care are:

• Out of Pocket (Check, credit card, cash) • Long Term Care Insurance • Veterans Aid and Attendance (if your loved one is a Veteran, or the widow or spouse of a Veteran you may qualify. Click on the link to learn more)

Many people ask if Medicare, Medicaid, or private insurances can pay for home care. The answer is usually no; private home care companies will not accept insurance.

There is a possibility that your insurance company may reimburse the cost of services, but you would need to investigate that yourself.

(Note: Medicare does pay for some, but not the kind we are talking about. I will explain that next.)

Private Home Care vs. Other Senior Care Options

This chapter will explain how private care compliments other senior care options, like nursing homes, assisted living, Medicare home care, and adult day.

In the last section, we mentioned certified home care (in Boston more commonly VNA – visiting nurse association)

VNA/Certified Home Care (Medicare)

VNA (visiting nurses association) and certified home Care provide care when a doctor orders that a senior qualifies for it, then Medicare pays for nurses, therapists, and home health aides to come to a senior’s home to help them get better, but the issue is that these visits are not long.

Most VNA or certified home care companies will visit a senior from anywhere from 15 minutes to an hour, two to three times a week; some get more; some get less depending on the different level of care.

Supplementing a VNA with Private Home Care

When someone gets VNA, private home care is available to provide care the VNA service can’t cover. If someone is a fall risk, has dementia, recovering from stroke or heart attack or has a broken bone they will need more than three hours a week of help.

Private home care companies work with your VNA to see when they will be coming in, so you do not get double the coverage. Our aides will be there when the VNA is not. This way you are getting the most amount of coverage for the dollar.

You do not need to be discharged from a rehabilitation center or a hospital to receive Medicare home care. You just need a doctor’s orders.

Assisted Living Facility (ALF)

Assisted living facilities can be great! They offer something private home care can not, a socially active community where people of the same age can be together. Some of you might be thinking of either private home care or an assisted living community.

Private home care and assisted living facilities work together is in two ways.

1) If you are on a waiting list to for an ALF, it can take weeks or months before the room is open. You can use private home care to make sure your mother or father is safe until they are ready to move in.

2) ALF are for seniors who need less than two hours of one on one care per day. If your loved one needs more than two hours of care per day, you will get a call from the facility informing you of this.

The community nurse will explain that your family member needs too much care. You will then have two options, move your loved one out, or hire a private home care company to come in to take care of you loved one.

Skilled Nursing Homes (SNF)

Like ALFs, nursing homes rely on the same principle, many people who need care, but not so much that a small group of aides and nurses need to be with them all the time.

Once someone is in a nursing home, they more than likely will not need private home care, but it does happen when someone needs so much care that the facility requires additional private home care.

An example of this would be a dementia patient that likes to wander but is a fall risk.

Adult Day Care

Adult day care is when you drop off your loved one in the morning and pick them up in the afternoon or early evening.

Not all families have the flexibility to be there to drop them off and pick them up. Private caregivers can help with getting them ready, transportation, and bring them home and care for them until their adult children arrive home.

Pro’s and Con’s of Private Home Care

As stated before this book is to inform you of everything related to private home care, so here are the pros and cons of home care services.

Drawbacks of Private Home Care

• The biggest drawback with home care is that a person is coming into your home to help a loved one in intimate and personal ways. Trusting this individual is important. They have access to the whole house, to medications, fine items, and are alone with your loved ones.

• There is not as much social activity. There is less social activity then in an assisted living or nursing home. So if your hope is to have your loved one in a community with many people their own age, then this would be seen as a drawback.

• You are paying someone to be available at a moment’s notice. There will be times when the caregiver is not as active as you like. Their job is not to clean the whole house, organize the garage or mow the lawn. Their job is to be available at any point in time your loved one needs them. Understandably, customers can get frustrated when they see a caregiver knitting, reading or watching tv with their loved one, but this does happen. Now, this does not mean a caregiver can sit in front of the TV all day, if there is work to be done they are expected to work, but there are down times, it comes with the job.

• The cost. It does get expensive, and for most it is out of pocket. Your finances and how long you will be needing private home care all factor into how much money you can spend on a home care company. Generally paying for private home care is less expensive than alternative out of pocket options.

Positives of Private Home Care

• You are receiving personalized care from a trained healthcare worker to provide assistance when you cannot be there to do so.

• It relieves stress. Everyone that comes in and talks to me is at the end of their ropes. Most of the time people are caring for their parent and their children at the same time. If this is you, you are known as the “Sandwich Generation.”

• Quality time is restored. Instead of being your parents servant you now become their child again. You no longer are spending your time cleaning up, showering, feeding, washing, and doing all the care giving for your loved one. You go back to spending quality time with your parent.

• They get to stay in their home. Most people want to live the rest of their golden years in their home. By offering private home care you grant them that wish. They will not be moved from their hous to and ALF, or a SNF.

When to Contact Private Home Care

The decision to contact a home care company, to sit down and speak with a representative is a great first step. It allows you to understand your options. There are times when private home care is perfect for families and sometimes not.

What we suggest to families is to see if they are sure they want to move forward with this type of care. Are there family members that are willing to help with a portion or all of the care needed? If so, exhausting those resources might be a first choice before moving forward with home care.

“There are times when private home care is perfect for families and other times not.”

Family members might be at odds when making decisions about a loved one. They can be at odds with what type of care they wish to choose. Before sitting down with any senior care providers, make sure everyone in the family is in agreement with the type of care that is needed. So that when you meet with potential private home care companies, you are there to decide on which company you want to use.

Choosing a Private Home Care Agency

There are a plethora of options depending on where you are looking for private home care. What do you want to ask when meeting with a private home care company and deciding who to put your trust into?

Here are a list of questions you can ask when interviewing a private home care company.

1. How long has the agency been in operation? 2. What services does the agency provide? 3. Is the agency accredited? 4. Is the agency certified by Medicare? 5. Is the care giving staff available 24 hours 7 days a week? 6. What are the fees? What do they cover? 7. What payment source does the agency take? (Medicare, Veterans Aid and Attendance, LTC Insurance, Private Insurance) 8. Is the agency licensed to operate in the state it resides? 9. How are caregivers screened? 10. Are all employees bonded and insured? 12. Who supervises the employees? How often? 13. Does the agency require a nurse or therapist’s assessment of the patients’ home care needs? 14. Does the agency consult the patients’ doctor? 15. Does the agency include the patient and family in care planning? 16. Are there a minimum number of hours required per visit? 17. Is there a maximum number of hours per week? 18. Does the company provide and explain their invoices? 19. How are emergencies handled? 20. How are changes in scheduling handled?

Minute Women Private Home Care

If you are in Concord, MA or one of the surrounding towns and are interested in private home care or just need some general questions answered, we are here to help. Even though we are a private home care company, we can help you no matter what services you are looking for even including if it is outside of Concord, MA. Give us a call at 781-862-3300 and you will talk with a live person about your private home care needs.

What are your thoughts on Private Home Care? Ask your questions below and get involved!